Marital Stress Affects the Hearts of Husbands and Wives Differently

Scientists have known for some time that marital stress can damage a person's heart, but now it turns out that the scenario is quite different for husbands and for wives.

For wives, the most damaging stress comes from hostility, either hers or his.

For husbands, it's the need to feel in control, and heart damage occurs when the wife asserts control, or when the husband feels the need to dominate his mate.

A new study from the University of Utah underscores the effects of marital stress in a measurable way. Researchers who studied 150 couples who had been married an average of 27 years found a direct correlation between different kinds of stress and hardening of the coronary arteries, or atherosclerosis, which can lead to heart attacks and possibly death.

The difference between the genders is quite pronounced, says psychologist Tim Smith, who led the research team. Women suffered heart damage in the presence of hostility, but men didn't. Conversely, men suffered coronary damage if their control was questioned, but women didn't.

Although the purpose of the study was to evaluate "interpersonal risk factors for coronary disease," Smith says, it probably says as much about gender identification and role-playing as it does about marriage.

Women need to feel loved and need to be treated with tenderness.

Men need to dominate, and play the role of the boss.

"How warm and friendly the relationship is, versus cold and hostile, seems to capture the attention more of women then men, and the opposite is true for dominance and control," says Smith, who presented the findings at a recent meeting of the American Psychosomatic Society, whose concern is the influence of psychological factors on physical health.

The findings are consistent with a large body of research showing that the quality of a marriage, or even just the fact of being married, can have a significant impact on health. But most of those earlier studies consisted of self-reporting by marriage partners, and the Utah team wanted to take it a step further.

In an effort to measure the impact of marital stress, the researchers recruited 150 couples, most of whom were in their 60s, and none of whom had any history of cardiovascular disease. They chose older couples because it takes years for calcification to build up in the arteries, and that's what they wanted to measure.

The couples, who were paid $300 for their services, were told they would be asked to discuss the source of stress in their marriage.

"We gave them sort of a top 10 list of things couples fight about," says Smith. "That included things like money (which always ranks near the top) in-laws, household responsibilities, vacations, kids and the usual stuff."

Each couple picked which subject they wanted to discuss. Then while seated in front of a video camera, they got into it.

Sometimes, the researchers say, the bickering got so intense that the couples were later referred to counselors.

A subsequent CT scan turned up the evidence the researchers had been looking for. Husbands and wives both showed some hardening of the arteries, but in response to different types of stress.

"What we find stressful depends on who we are," Smith says, "and one of the aspects of who we are is gender."

But why should there be such a difference? Smith points out that numerous research projects in recent years have demonstrated something most of us already knew. Men are different from women.

That applies to disease, just as it does to social relationships. One recent study from the Mayo Clinic, for example, revealed that mental stress affects women's hearts more than men's. The study also showed that the rate of coronary disease has declined among men but not among women.

Other studies have shown that men are particularly concerned about the level of control in social situations, including close relationships. Guys want to be the top dog, regardless of the arena.

That shows up in many ways, Smith says, including the situation in which a man finds himself married to a woman who has a higher education, or, more important, job, than he does Those men are in danger of increased coronary risk, Smith says, a finding that left some researchers wondering "what the heck is that all about."

"One of the interpretations is that situation poses a low level but chronic status challenge," he says.

The Utah research may trouble some because the findings are based on a single, six-minute videotaped session with each couple, but Smith insists that meets commonly practiced standards.

"You have to be cautious when drawing broad, sweeping conclusions on the basis of one session," he says. "The assumption is we are getting a snapshot of a long-standing relationship. That's probably not way off base."

As he notes, the research is also consistent with other findings, and it does offer a way to measure the actual coronary impact of various types of marital stress.

It doesn't rank up there with smoking or obesity or lack of exercise in terms of heart disease, he adds. But it probably belongs somewhere on the list.

And it suggests that spats with a spouse may be a lot more serious than we might have thought. Maybe, given enough time, those fights could kill you.